Tuesday, January 7, 2014

Life after Abuse

A large part of what I do in psychotherapy with people as a Clinical Psychologist falls under the category of abuse recovery. Abuse is a broad term, encompassing physical, sexual, and emotional abuse. Sometimes, abuse is a one-time event by an abusive acquaintance of stranger. At other times, there is an ongoing abusive relationship with a parent, stepparent, relative, coach, teacher, religious leader, spouse, sibling, close friend or even an adult child.

When a child is abused, especially when the abuse is repeated by someone who has an ongoing relationship with the child, there are often long-term mental health consequences reaching into adulthood. It is hard to know who to trust and how to build a trusting relationship when you were abused and/or not protected from abuse by adults around you as a child. It is hard to know how to tolerate emotional pain when you have years of experiencing sometimes truly intolerable pain in isolation with no relief other than addictive behaviors that distract and numb.

How do you recover from abuse? Abuse recovery has several important components, including:

1) Finding a Safe Environment. When you are in regular contact with people who abuse you, especially when you live with them, abuse recovery is challenging. Leaving an abusive relationship is very difficult for many people with abuse histories because abuse feels "normal" and because it can be risky on multiple levels to limit or end those relationships.

2) Stopping self-destructive behaviors. Self-destructive behaviors such as restrictive or binge eating, self-harm behaviors, suicidal thoughts /actions, and addiction(s) to drugs and/or alcohol are often what brings people with childhood abuse histories to therapy. While books and seminars can be helpful, do not feel ashamed if you haven't been able to stop them on your own. In my practice, I use DBT frequently to help people with these behaviors.

3) Finding Trustworthy People. This is paradoxical for many abuse survivors. On the one hand, learning how to trust and getting the support of trustworthy people is absolutely essential for abuse recovery. On the other hand, most people with significant histories of abuse have a difficult time knowing who to trust and how much to trust them. Psychotherapy can be an excellent place to learn how to develop trusting relationships. However, not all therapists are equally trustworthy nor will all of them be a good fit for you, your personality, and your set of issues. It is important to hold out for a therapist who is competent in abuse recovery and who feels potentially trustworthy to you.

4) Disclosing the Abuse. It is extremely difficult to recover from abuse without speaking of it to anyone. Unfortunately, some people have had the experience of disclosing the abuse and not being believed or, worse, being abused by the person they trusted enough to disclose the abuse. If this is you, it is even more important to work toward telling someone who can validate that you were abused and that it was not okay. If you want therapy but cannot imagine talking about the abuse, know that it's normal to build a relationship with your therapist before disclosing your abuse. Finally, at some point in your therapy, you may find it helpful to talk about the abuse in detail, either by simply talking to your therapist and/or using additional methods such as EMDR, EFT, or Hypnosis.

5) Building a Life after Abuse. What kind of person do you want to be? What do you want your relationships to be like? What matters to you the most? What do you value? Where do you want to go in your future? These are the questions you will start to answer more fully as you build your life after abuse. Before dealing with the abuse, many people find their lives are centered on pain relief and avoidance. Once you do not need to expend energy numbing yourself and avoiding painful situations, you will free up a lot of energy that can be channeled into building a life worth living for you and the people you love.